Wiki add on codes 11045-11047

[coder1]

Our add on codes are being denial from MCR as duplicates. My understanding is that the surface area for the same depth debridement is added together.

for example: multiple 43 debridements equal to 45 Sq Cm

this would be coded with a 43 debridement and 2x 46 add on codes ???

Medicare reimburse for one add on code but denied the second one as duplicate

This is for all the claims with mutliple add on codes.

should I use a modifier on the add on code????

 

[MMAYCOCK]

add on codes

Our add on codes are being denial from MCR as duplicates. My understanding is that the surface area for the same depth debridement is added together.

for example: multiple 43 debridements equal to 45 Sq Cm

this would be coded with a 43 debridement and 2x 46 add on codes ???

Medicare reimburse for one add on code but denied the second one as duplicate

This is for all the claims with mutliple add on codes.

should I use a modifier on the add on code????

I'm not sure I understand exactly how you're billing, but the correct way to bill the above assuming it's sub q is:

If this was sub q depth, 11042,
11042 x 1 (first 20 sq cm) so that leaves 25 sq cm to bill.
11045 x 2 the remainder of the wound area.